Eficácia do travoprosta 0, 004% na redução da pressão intraocular em pacientes com glaucoma / Travoprosta 0, 004% efficacy in intraocular pressure in patients with glaucoma

Resumo Objetivo: avaliar a eficácia do colírio TRAVAMED® (travoprosta 0,004%) (Ofta, Brasil) na redução da pressão intraocular (PIO), em pacientes com glaucoma primário de ângulo aberto (GPAA) ou hipertensão ocular (HO), bem como avaliar os efeitos colaterais decorrentes do uso da droga. Métodos: estudo randomizado, controlado, com 70 olhos de 38 pacientes acima de 18 anos de idade, com diagnóstico de GPAA ou HO. Todos os pacientes receberam o colírio TRAVAMED® como primeira droga a ser introduzida no tratamento, tendo sido utilizada uma gota uma vez ao dia (à noite), e 30 dias após foram submetidos à tonometria de aplanação (Goldmann) para mensuração da PIO, com o mesmo examinador, no mesmo tonômetro e nos mesmos horários. Resultados: A média de redução da PIO após 30 dias de uso do TRAVAMED® foi de 7,46 mmHg. Em relação aos efeitos colaterais, 15,71% (11) dos olhos apresentaram hiperemia conjuntival, 8,57% (6) apresentaram dor, 8,57% (6) apresentaram ardência, 2,86% (2) apresentaram embaçamento visual e em 1,56% (1) dos olhos não houve queda significativa da PIO. Conclusão: A medicação TRAVAMED® foi eficiente na redução da PIO após 30 dias de uso contínuo, na dose de 1x/dia. Acerca dos efeitos colaterais, os mais observados foram hiperemia ocular (15,71%), dor (8,57%) e ardência (8,57%), porém estudos com maior tempo de seguimento se fazem necessários.

Abstract Objective: to evaluate how much decreases intraocular pressure (IOP) with TRAVAMED® (travoprost 0,004%) (Germed, Brazil) in patients with primary open angle glaucoma (POAG) and ocular hypertension (OH) and possible side effects. Methods: controlled and randomized study, it was evaluated 70 eyes of 38 patients with age of 18 years old or more diagnosed with POAG and OH. All the patients had TRAVAMED® as first drop for treatment used once daily (at night) and 30 days later they had IOP measured by Goldmann tonometry, with the same examiner in the same tonometer at the same times. Results: the mean decrease in IOP was 7,46 mmHg after 30 days using the drops. 15.71% (11) of eyes had conjunctival redness, 8.57% (6) had pain, 8.57% (6) had burning, 2.86% (2) had blurring vision and 1.56% (1) of the eyes there wasn't a significant reduction in IOP. Conclusion: TRAVAMED® was efficient when evaluating IOP decrease. The most correlated side effects were conjunctival redness (15.71%), pain (8.57%) and burning (8.57%), but studies with longer follow-up are needed.

Effects of prostaglandin analogs on blood flow velocity and resistance in the ophthalmic artery of rabbits / Efeitos dos análogos da prostaglandina na velocidade do fluxo sanguíneo e resistência na artéria oftálmica de coelhos

ABSTRACT Purpose: The aim of this study was to investigate the effects of prostaglandin analogs on blood flow in the ophthalmic artery of clinically healthy rabbits. Methods: Fifty-five clinically healthy New Zealand white rabbits were divided into six groups, and the left eyes were treated for four weeks with the preservative benzalkonium chloride (BAK) only or a topical formulation of different prostaglandin analogs (bimatoprost BAK, tafluprost BAK-free, travoprost BAK, travoprost POLYQUAD, and latanoprost BAK). Color Doppler imaging was performed before and after the treatments. The mean values of the peak systolic velocity (PSV) and end diastolic velocity and the resistive index (RI) were calculated. Statistical analysis was performed to compare the differences pre- and post-treatment for each drug and post-treatment among the drugs. Results: The prostaglandin analogs did not affect PSV. Bimatoprost BAK, travoprost POLYQUAD, and latanoprost BAK did not change RI. Tafluprost BAK-free and travoprost BAK therapy resulted in similar reductions in RI. No significant differences pre- and post-treatment were found when BAK was administered alone. Conclusion: The prostaglandin analogs tafluprost BAK-free and travoprost BAK improved blood flow in the ophthalmic artery in healthy New Zealand white rabbits, which suggests that these drugs enhance the prevention of the progression the progression of glaucoma.

RESUMO Objetivo: O objetivo deste estudo foi investigar os efeitos dos análogos da prostaglandina (PGAs) no fluxo sanguíneo da artéria oftálmica em coelhos. Métodos: Cinquenta e cinco coelhos da raça Nova Zelândia clinicamente saudáveis foram divididos em seis grupos para tratamento com formulação tópica de diferentes APGs (bimatoprosta BAK, tafluprosta BAK-free, travoprosta BAK, travoprosta POLYQUAD e latanoprosta BAK) e formulações contendo apenas o conservante cloreto de benzalcônio (BAK). Foi realizada ultrassonografia com Doppler antes e após os tratamentos. Os valores do pico da velocidade sistólica (PSV) e da velocidade diastólica final foram obtidos e o índice de resistência (RI) foi então calculado. A análise estatística foi realizada para comparar as diferenças entre cada droga no pré e pós-tratamento, além das diferenças no pós-tratamento entre as drogas. Resultados: Estes colírios PGAs não afetaram o PSV. A bimatoprosta com o conservante BAK, travoprosta com o conservante POLYQUAD e latanoprosta com o conservante BAK não alteraram o RI. Já o tratamento com tafluprosta sem conservante (BAK-free) e travoprosta com o conservante BAK promoveram redução similar dos valores do RI. Não houve diferença significativa na comparação entre valores pré e pós-tratamento quando BAK foi administrado isoladamente. Conclusão: Os PGAs tafluprosta BAK-free e travoprosta BAK melhoraram o fluxo sanguíneo na artéria oftálmica em coelhos da raça Nova Zelândia sugerindo que estes medicamentos possam contribuir na prevenção da progressão do glaucoma.

Neuroprotective Effects of Betaxolol Mediated by Heme Oxygenase-1 Induction in RGC-5

PURPOSE: To evaluate the neuroprotective effects of betaxolol (betaxolol hydrochloride) under hypoxic conditions using retinal ganglion cells (RGC-5) and determine whether heme oxygenase-1 (HO-1) expression exerts cytoprotective effects. METHODS: In this study, cultured RGC-5 cells were incubated with different concentrations of betaxolol hydrochloride (0.1 microM, 1 microM or 5 microM) and with 10 microM zinc protoporphyrin (ZnPP), in a hypoxia incubator (1% O2, 5% CO2, 94% N2) for 48 hours and the cell viability of each group was determined. Additionally, cell viability was measured after RGC-5 cells were incubated with 5 microM of brinzolamide (Azopt(R)), brimonidine tartrate (Alphagan(R)) or travoprost (Travatan(R)). RGC-5 cells were divided into three groups and incubated under three different conditions, normoxia group (20% O2, 5% CO2), hypoxia group (1% O2, 5% CO2) and the group with 5 microM of Betoptic S(R) treated under hypoxic conditions (hypoxia, Betoptic S(R)). After incubation for 4, 8, 12 and 24 hours, HO-1 expression was analyzed using Western blotting. RESULTS: Cell viability significantly increased in RGC-5 cells treated with Betoptic S(R) compared with other antiglaucoma agents. Increased levels of HO-1 expression indicate its relevance in cell viability. Furthermore, increased RGC-5 cell viability by Betoptic S(R) was significantly reduced in the HO-1 inhibitor ZnPP-treated group. CONCLUSIONS: We reaffirmed the known cytoprotective effects of Betoptic S(R) and the results suggests that HO-1 expression exerts cytoprotective effects against hypoxia.

Hypertrichosis and Hyperpigmentation in the Periocular Area Associated with Travoprost Treatment

No abstract available.

Comparing the Efficacy of Latanoprost (0.005%), Bimatoprost (0.03%), Travoprost (0.004%), and Timolol (0.5%) in the Treatment of Primary Open Angle Glaucoma

PURPOSE: To compare the efficacy and safety of latanoprost, bimatoprost, travoprost and timolol in reducing intraocular pressure (IOP) in patients with primary open angle glaucoma. METHODS: This was a prospective study conducted at a tertiary-care centre. One hundred and forty patients with newly diagnosed primary open angle glaucoma were randomly assigned to treatment with latanoprost (0.005%), bimatoprost (0.03%), travoprost (0.004%) or timolol gel (0.5%); 35 patients were assigned to each group. All patients were followed for 2, 6, and 12 weeks. The main outcome measure studied was the change in IOP at week 12 from the baseline values. Safety measures included recording of adverse events. RESULTS: The mean IOP reduction from baseline at week 12 was significantly more with bimatoprost (8.8 mmHg, 35.9%) than with latanoprost (7.3 mmHg, 29.9%), travoprost (7.6 mmHg, 30.8%) or timolol (6.7 mmHg, 26.6%) (ANOVA and Student's t-tests, p < 0.001). Among the prostaglandins studied, bimatoprost produced a maximum reduction in IOP (-2.71; 95% confidence interval [CI], -2.25 to -3.18) followed by travoprost (-1.27; 95% CI, -0.81 to -1.27) and latanoprost (-1.25; 95% CI, -0.79 to -1.71); these values were significant when compared to timolol at week 12 (Bonferroni test, p < 0.001). Latanoprost and travoprost were comparable in their ability to reduce IOP at each patient visit. Ocular adverse-events were found in almost equal proportion in patients treated with bimatoprost (41.3%) and travoprost (41.9%), with a higher incidence of conjunctival hyperemia (24.1%) seen in the bimatoprost group. Timolol produced a significant drop in heart rate (p < 0.001) at week 12 when compared to the baseline measurements. CONCLUSIONS: Bimatoprost showed greater efficacy when compared to the other prostaglandins, and timolol was the most efficacious at lowering the IOP. Conjunctional hyperemia was mainly seen with bimatoprost. However, the drug was tolerated well and found to be safe.

Efectividad y seguridad de travoprost para reducción de la presión intraocular en pacientes con glaucoma de ángulo abierto, glaucoma de ángulo cerrado o presión intraocular elevada / Effectiveness and safety of travoprost for reduction of intraocular pressure in patients with open-angle glaucoma, angle-closure glaucoma or elevated intraocular pressure

Introducción: Antecedentes: Descripción de la condición de salud de interés: El glaucoma se define como una neuropatía óptica con daño estructural del nervio óptico acompañado de una disfunción visual secundaria (1). Un daño leve del nervio óptico puede ser asintomático; 50% de los pacientes en países desarrollados con glaucoma pueden no saber que padecen de dicha enfermedad (2-3) . Sin embargo, conforme la enfermedad avanza los síntomas se instauran y empeoran reduciendo la visión periférica, la sensibilidad al contraste, entre otras funciones propias de la visión, comprometiendo la realización de las actividades diarias y en última instancia, el desarrollo de ceguera. Descripción de la tecnología: El tratamiento farmacológico para el glaucoma busca disminuir la presión intraocular a un nivel que sea seguro para el paciente, disminuyendo la producción de humor acuoso o aumentando la salida del mismo del ojo, con el fin de evitar la aparición de ceguera por glaucoma. Evaluación de efectividad y seguridad: Pregunta de investigación: En pacientes con Glaucoma de Ángulo Abierto o Cerrado o con Presión Intraocular elevada, ¿es más efectivo y seguro el travoprost en comparación con brimonidina, timolol, latanoprost, acetazolamida, pilocarpina, betaxolol, tafluprost o bimatoprost para reducir la presión intraocular? La pregunta de investigación fue validada teniendo en cuenta las siguientes fuentes de información: registro sanitario INVIMA, Acuerdo 029 de 2011, guías de práctica clínica, reportes de evaluación de tecnologías, revisiones sistemáticas y narrativas de la literatura, estudios de prevalencia/incidencia y carga de enfermedad, consulta con expertos temáticos, y otros actores clave. Criterios de elegibilidad de la evidencia: Criterios de inclusión: Población. Adultos con diagnóstico de hipertensión intraocular, glaucoma de ángulo abierto o de ángulo cerrado. Tecnología de interés: Travoprost. \r\nComparadores: brimonidina, timolol, latanoprost, acetazolamida, pilocarpina, betaxolol, tafluprost y bimatoprost. Desenlaces: Reducción de la presión intraocular; Eventos adversos. Discusión: Para el tratamiento de glaucoma hay varias opciones terapéuticas, enumeradas anteriormente, y por tanto puede ocurrir que no hayan comparaciones directas entre ciertos tratamientos (comparaciones cabeza a cabeza) y en ocasiones es necesario apoyarse en evidencia indirecta como en los mata-análisis en red. Los resultados de los meta-análisis en red presentados en este reporte difieren en cuanto a la efectividad al comparar travoprost contra timolol, uno reporta una efectividad mayor del travoprost mientras que el otro estudio no reporta diferencias estadísticamente significativas. No obstante otro estudio que reportó esta comparación, apoya una mayor efectividad del travoprost versus timolol. La comparación de latanoprost y travoprost fue reportada por dos estudios y ambos concuerdan en que tiene una efectividad similar. Sin embargo, contra bimatoptost, que es el otro miembro de la familia de los análogos de prostaglandinas, también ha divergencias en cuanto a las conclusiones, sin embargo el meta-análisis que incluyo más estudios primarios da cuenta de una mayor efectividad para el bimatoprost. El tratamiento con travoprost se asocia con mayores eventos adversos, hiperemia conjuntival, que timolol, bimtatoprost y que el latanoprost. A pesar de que es un evento adverso meno, es importante tener en cuenta que dicho evento adverso puede impactar en la adherencia al tratamiento y por ende los pacientes con la presencia de hiperemia conjuntival pueden abandonar el tratamiento. Conclusiones: -Efectividad: travoprost es más efectivo que el timolol para reducir la presión intraocular. No hay diferencias estadísticamente significativas entre travoprost y latanoprost. Entre travoprost y bimatoprost no hay resultados concluyentes sobre diferencias en efectividad. No se identificó evidencia para comparaciones contra brimonidina, latanoprost, acetazolamida, pilocarpina, betaxolol, tafluprost y bimatoprost; -Seguridad: travoprost tiene una mayor probabilidad de desarrollar hiperemia conjuntival, el cual es un evento secundario menor, cuando se compara frente a timolol, bimatoprost y latanoprost. No se identificó evidencia para comparaciones contra brimonidina, latanoprost, acetazolamida, pilocarpina, betaxolol, tafluprost y bimatoprost.(AU)

Impact of combination use of 0.004% travoprost and 2% pilocarpine on matrix metalloproteinases synthesized by rabbit ciliary muscle: a pilot study / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To explore the impact of combination use of prostaglandin analogue and cholinergic agonists on main matrix metalloproteinases (MMPs) synthesized by albino rabbit ciliary muscle.</p><p><b>METHODS</b>Normal adult albino rabbits were divided into the control group, 2% pilocarpine group, 0.004% travoprost group and travoprost plus pilocarpine group. Two rabbits in the control group were executed after treated with normal saline for one day. Two rabbits were separately executed on the 7th, 14th and 24th day of the treatment in each drug treated group. In each subgroup ciliary muscle band of 4 eyes was taken and made into homogenate. The MMPs activities of 10 subgroups were assayed by zymography. Bands' intensity which represents the activity of MMPs was measured by the UltraViolet Illumination system.</p><p><b>RESULTS</b>A bright band of MMP-1/2 was showed on each lane at the position corresponding to the molecular weight of 62 kD in the ciliary smooth muscles electrophoresis. When ion Zn and Ca was displaced by MMPs inhibitor EDTA, this bright band disappeared. Compared with the control group, MMP1/2 activity increased by 4.0%, 4.1% and 14.0% after 7, 14 and 24 days of pilocarpine treatment. Corresponding data was 23.2%, 61.7% and 111.5% in the travoprost group and 49.3%, 68.0% and 88.4% in the travoprost plus pilocarpine group.</p><p><b>CONCLUSIONS</b>Pilocarpine has little effect on activity of MMP1/2. Travoprost can increase activity of MMP1/2 gradually. Activity of MMP1/2 is rapidly increased by pilocarpine combined with travoprost, but shows small change with the prolonged treatment.</p>

Reactivation of Herpetic Keratitis in a Patient after Using Two Different Prostaglandin Analogues

PURPOSE: To report a case of herpetic keratitis after administration of two different prostaglandin analogues. CASE SUMMARY: A 68-year-old female with a history of herpetic keratitis in her right eye after using latanoprost seven years previous presented with redness, mild ocular pain and tearing in the same eye. She had also been prescribed travoprost eye drops for both eyes for uncontrolled glaucoma one month earlier. The cornea in her right eye showed a dendritic epithelial defect with focal epithelial erosions. Travoprost treatment was discontinued, and the herpetic keratitis recovered completely in ten days with acyclovir ointment and oral agent. No further recurrence was observed in the following six months.

Intraocular pressure lowering efficacy and safety of travoprost 0.004% as a replacement therapy in patients with open angle glaucoma or ocular hypertension / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Travoprost has been widely used for the treatment of patients with open-angle glaucoma (OAG) or ocular hypertension (OH). The aim of this study was to evaluate the intraocular pressure (IOP) lowering efficacy of travoprost 0.004% monotherapy in patients previously treated with other topical hypotensive medications, and in previously untreated patients.</p><p><b>METHODS</b>This open-label, 12-week study in 1651 adult patients with ocular hypertension or open-angle glaucoma who were untreated or required a change in therapy (due to either inadequate efficacy or safety issues) as judged by the investigator was conducted at 6 sites in China. Previously treated patients were instructed to discontinue their prior medications at the first visit. All the patients were dosed with travoprost 0.004% once-daily at 8 p.m. in both eyes for 12 weeks. Efficacy and safety evaluations were conducted at week 4 and 12. IOP measurements were performed at the same time of day at the follow-up visits.</p><p><b>RESULTS</b>For patients transitioned to travoprost, mean IOP reductions from baseline in untreated and treated patients with different prior medications at week 12 were: latanoprost, (4.3 +/- 4.6) mmHg; beta-blocker, (6.3 +/- 4.0) mmHg; alpha-agonist, (7.5 +/- 4.3) mmHg; topical carbonic anhydrase inhibitors, (8.0 +/- 4.9) mmHg. All mean IOP changes from baseline were statistically significant (P < 0.001). No treatment-related serious adverse events were reported in this study.</p><p><b>CONCLUSIONS</b>In patients treated with other hypotensive medications or untreated, the IOP reduction with travoprost was significant. The results of this study demonstrated the potential benefit of using travoprost as a replacement therapy in order to ensure adequate IOP control. Travoprost administered once daily was safe and well tolerated in patients with glaucoma or ocular hypertension.</p>

The Effects of Prostaglandin Analogues on the Corneal Thickness

PURPOSE: To evaluate the effects of prostaglandin analogues on the corneal thickness of patients with primary open-angle glaucoma (POAG) or normal tension glaucoma (NTG). METHODS: This study included 130 eyes of 65 patients who were diagnosed with POAG or NTG. All patients were divided into two groups; one group received prostaglandin analogues, while the other group received alternative ocular hypotensive eyedrops. Corneal thickness, best corrected visual acuity, and flare in the anterior chamber were measured and compared before treatment and at least 24 months (mean: 27 months) after treatment. RESULTS: The mean decrease in corneal thickness was statistically significant in the group using prostaglandin analogues, but not in the control group. Among the various prostaglandin analogues used, travoprost and latanoprost decreased mean corneal thickness, but bimatoprost had no effect. Best corrected visual acuity, refraction power, and flare in the anterior chamber did not change significantly in either group of patients when ocular hypotensive eyedrops were used. CONCLUSIONS: Prostaglandin analogues lower intraocular pressure and decrease corneal thickness if used over a 24 months.

A double blind randomized controlled trial using topical application of travoprost 0.004% (40 µg/ml) vs placebo to induce hair growth among healthy male volunteers with androgenetic alopecia

BACKGROUND: Androgenetic alopecia (AGA) is the most common type of hair loss affecting men. Prostaglandin analogues are a new class of antiglaucoma agents documented to have localized and possibly permanent hair growth OBJECTIVE:To obtain quantitative evidence of the hair-inducing properties of travoprost (0.004%) vs a placebo METHODS: Included are twenty healthy male subjects with male pattern baldness types III to VII based on the Hamilton Norwood Scale for pattern of hair loss. Participants applied the substances onto the test sites of the scalp twice daily. Baseline photos and bimonthly photographs were taken. Hair growth was evaluated during each follow-up in terms of hair density and hair type and manual hair count was done. Repeated measure analysis was performed with a level of significance set at 0.05RESULTS: After 8 weeks of treatment, there was no significant difference in total hair density between the travoprost and the placebo groups (p=0.49). No significant difference was demonstrated in the number of vellus, intermediate and terminal hair at different follow-up periods using travoprost and placebo(p=0.66, p=0.86, p=0.89)CONCLUSION: The use of topical travoprost 40 mg/ml did not induce statistically significant hair growth in the bald scalps of human subjects.